Persistent Labial Minora Fusion in Reproductive Age Women: A Retrospective Case Series of Nine Patients and Review of Literature

Abstract

Labial minora fusion persisting to the reproductive age is a rare type of labial fusion. Only 17 sporadic case-reports have been published to describe this disease. We report a retrospective cohort study of nine patients undergone surgical dissections in our hospital with labial minora fusion of reproductive age. General information, a medical history, gynecological examinations, preoperative ultrasonography and observations during surgery were reviewed. Four patients found vulva deformity at age 1.25 ± 1.09 years, and the remaining 5 patients discovered the disease when they reached child-bearing age (25.20 ± 4.31). The average age of operation was 22.89 ± 6.21 years. The characteristic symptoms of the disease were menstrual blood and urine excretion from the urethral orifice. No endometriosis was detected in all 9 patients. One patient was found to have congenital defects, with a double cervical and complete uterine septum. All patients recovered well without re-adhesion. Seven patients (7/9, 77.80%) were interviewed by telephone. Three patients had normal sexual life and all patients were able to control urination normally. This labial fusion was found in 44.44% patients shortly after birth and might combined with other defects, suggesting a congenital nature of the disease, and further indicates the developmental feature of the vulva.

Keywords: Congenital defects; labial adhesion; labial minora fusion; sexual function; urinary function.

Figure 1.

Procedure for labial fusion dissection. (a, b) Overview of the fused labial minora. Only the urethra meatus was visible. (c) A metal urethral catheter was inserted as a guide to avoid urethral injuries. (d) The fused labial minora were separated, and the vagina was revealed to have a normal width. (e) A normal cervix was evident. (f) The edges of the incision were sutured with 1/0 coated VICRYL separately